(RNN) – As obesity in the United States rises, it is little wonder the overall perception about body image is going in the opposite direction.

It is estimated that 10 percent of females between the ages of 10 and 20 struggles with bulimia, and 4 percent of women in college have the eating disorder, according to information released by Insight Behavioral Health Centers in Chicago.

Dr. Susan McClanahan, co-founder and co-director of Insight, said that trend is due to a variety of factors both inside and outside the home.

The tendency to undereat spins from a cycle that repeats itself in almost every female-to-female relationship, and everything from media to retail companies fuels the problem.

"You say, ‘I'm ugly, I'm fat,' and your friend says, ‘Oh no, you're pretty. I'm fat," McClanahan said. "You hear it from peers and from your parents, and the standard of beauty has gotten thinner and thinner. Now you see size double zero in stores. These negative standards have an effect on self-esteem.

"When we try to restrict food, metabolism slows down. It's hard for girls to accept that by eating more, your metabolism will rev back up."

Grim forecasts about what our waistlines will eventually look like don't help the situation much.

Trust for America's Health released projections in September that nearly half of people in every state would be obese by the year 2030. Federal health officials revealed similar predictions that more than 40 percent of the population would become obese during the same period.

Obese people are included in the two-thirds of the U.S. population currently overweight.

However, more evidence is suggesting healthy weight cannot be confined to an ideal number, such as one proposed by the highly debated Body Mass Index that measures body fat based on a person's weight and height.

The number of thin people that develop diabetes has continued to baffle doctors, and they are still trying to pinpoint genetics as the most probable factor.

Additional studies have shown that among people with diabetes or cardiovascular diseases, overweight or moderately obese people have a better chance of living longer.

That's not a license to eat anything we want, but it's possibly a wake-up call to overhaul the way nutrition and fitness are looked at.

"I think obesity is a more confounding variable. There's now this ‘health at every size' movement," McClanahan said. "Whatever your natural body weight, there has to be more self-acceptance there. Just because you see an overweight kid, that doesn't mean he's overeating. I don't think we can control our shape and weight as much as we think we can.

"Do we have to be morbidly obese? No. But fit doesn't mean running marathons."

The mental dangers of poor eating and negative body image are just as rampant as those physical.

The risk of death for people with anorexia is 18 times that of others in the general population, according to the National Institute on Mental Health. Only one in 10 people with an eating disorder receives treatment.

The problem is not confined to girls and women. Those symptoms could possibly pose higher dangers among males because of the tendency to overlook them.

It is estimated that as much as 20 percent of anorexics are males, but the American Psychological Association reported men are less likely to seek treatment for eating disorders because of the perception they are "women's diseases."

"It seems there's the same kind of pressure on boys to have six-pack abs and be really buff," McClanahan said. "Some could do sit-ups all day and won't have that. You have a lot of boys walking around thinking they're fat. I think people miss it a lot. We don't expect that from boys. Boys struggle with that just as much as girls do, and boys need reinforcement, too."

Fad dieting is especially dangerous for young people, whose bodies are still in the formative stages, McClanahan said.

Even the people we're expected to look to as the standard have struggles with body image and eating.

Actress Hayden Panettiere (Heroes, Nashville), whose 5'1" frame many women would kill to have, revealed in a recent interview with Women's Healththat she developed body dysmorphia caused by a negative tabloid photo.

Body dysmorphia is a mental illness that causes people to obsess over an imagined physical defect or a minor defect that is visible to no one else. People can perceive themselves as ugly and turn to plastic surgery or avoid social interaction.

"Really, there is no correlation between looks and happiness – zero," McClanahan said. "Look at Hollywood. Do they seem happy? Marriages are breaking up all the time. [There has to be] balance and moderation and some self-acceptance. I think there is a natural desire to achieve and excel. I don't think you have to force that on people."